The TAC is committed to protecting the funds and other assets placed under its control and protection for the benefit of the people of Victoria. Fraud represents potential risks to these funds and assets.

The TAC will not tolerate fraudulent or corrupt activities against its interests and will vigorously pursue parties engaged in such practices or attempting to do so.

How to make a report

Should you wish to make a report of fraudulent behaviour or other breaches of the TAC legislation, please contact the TAC's Fraud and Compliance Group by emailing Fraud_Compliance@tac.vic.gov.au or by calling 1800 332 556.

Fraud and the TAC

Fraud is dishonest activity or potential financial loss to the TAC including theft of moneys or other property by employees or persons external to the TAC. This includes:

the deliberate falsification, concealment or destruction of documentation

falsified documentation used or intended for use for a normal business purpose

Actions that may be taken by the TAC

Determine whether civil action should be taken to recover compensation amounts overpaid

Refer the matter to the Victoria Police, the Coroner, the Office of Public Prosecutions (OPP) or another body (including professional or trade regulatory bodies such as the Australian Health Practitioner Regulation Agency (AHPRA) and the Legal Services Board) or

Take no further action.

Any employee found to have engaged in, or concealed any such behaviour, may be disciplined, and their employment may be terminated.

TAC billing review program

The TAC has a Billing Review Program to ensure that payments for services provided to TAC clients are reasonable and appropriate. For more information please refer to:

Prevention, Detecting and Investigating Fraud 2017/18

The TAC continues to focus on enhancing its toolkit of analytical methods and intelligence reporting techniques in order to identify known and unknown behaviours indicative of potential fraud or claim anomalies. The ongoing development and refinement of this capability is crucial in ensuring effective support of strategic business change through proactively identifying, preventing and investigating potential fraud and other inappropriate payments in a timely manner.

When endeavouring to reduce fraud and change client /provider behaviour across the scheme the following enforcement action was taken during 2017/18.

There were 13 prosecutions finalised through the Magistrates Court. In all cases the TAC client registered a guilty plea. A total of $216,000 in restitution was awarded to the TAC. Seventeen (17) matters are currently before the courts at various stages where TAC is alleging fraud against the scheme totalling $401,099. Cases that haven’t met the prosecution threshold are dealt with through TAC’s principal means of achieving prompt voluntary compliance sending fifty one (51) warning letters for breaches of the Act relating to fraud and providing false information to the TAC by clients, Medical and Service Providers incorporating demands for reimbursement. The Forensics Group continue to be ambitious, leading industries best practice to combat fraud and corruption. Significant effort and drive into the Australian & New Zealand Interagency Fraud Association (ANZIFA) attended by various state and federal agency across Australia and New Zealand. The association’s purpose is to foster a proactive community, committed to minimising the impact of fraud, waste and abuse.

Provider Review

During 2017/18 the Forensics Group continued its focus on ensuring payments made to medical and health practitioners and other service providers were appropriate and complied with the Transport Accident Act and relevant TAC policies and fee schedules. A number of new analytical products and techniques were created and utilised to detect inappropriate payments throughout the year. Reviews were completed on over 5,610 payments made to 2099 providers across a wide range of different disciplines. Over $459,000 was reimbursed to the TAC for payments received by providers that they were not entitled to..

During the plea in mitigation the accused made representation that he was willing to repay all monies owed to the TAC immediately. The accused repaid the full amount owed to the TAC being $5,262.50 and $500 in TAC costs prior to sentencing by the magistrate.

12 Month Community Corrections Order with conditions: The conditions of the order were that the accused perform 150 hours of unpaid community work, undergo mental health assessment and treatment and undergo programs to reduce the chances of re-offending.

12 Month Community Corrections Order with conditions: The conditions of the order were that the accused be under the supervision of the Office of Correction for the duration of the order, that the accused undergo drug assessment and treatment and undergo assessment and treatment for mental health issues.

The appeal was heard on 21/03/2018 and His Honour Judge Higham at the Melbourne County Court on the two charges as previously appealed to a 12 month Community Corrections Order, with conditions that the accused be under the supervision of the Office of Corrections for the entire time and that the accused perform 100 hours of unpaid community work. The judge also ordered that the accused pay the TAC compensation in the amount of $44,529.98

Her Honour Judge Campton suspended the sentence for 12 months. Her Honour identified that the accused had no significant priors, the plea of guilty and the amount involved compared with other cases warranted that the sentence be suspended rather than an immediate term to serve.

Restitution of $34,854.29 to be paid in monthly instalments of $100.00

Fine of $4,000

18 Month Community Corrections Order – the accused to perform 200 hours of unpaid community work, undergo assessment and treatment for mental health issues and participate in offender behaviour programs to help reduce re-offending